A study supported by the NIHR ARC Oxford Thames Valley and NIHR Oxford Health BRC is among six new projects worth a total of £2m, funded by UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR) in response to Covid-19, will give a much-needed boost in support for research investigating the impact of the pandemic on mental health.
They will focus on reducing the negative effects on the mental health of three at-risk groups: healthcare workers, children and younger people, and those with serious mental health problems.
The ARC Oxford and Thames Valley and Oxford Health BRC study is among three projects that will specifically focus on children and younger people, and w ill test whether a parent-led online therapy programme can help treat children who have anxiety, either as a pre-existing mental health problem or as a new condition linked to the pandemic. Th two other projects using existing cohorts to assess the impact of the Covid-19 pandemic and subsequent social restrictions on the mental health of teenagers.
The largest of the six projects, worth £0.5m, seeks to understand and mitigate the psychosocial impact of the pandemic on NHS staff in England. There have been recent reports of NHS staff facing a mental health crisis, but these reports have not yet been validated by large-scale population studies with sufficient numbers of healthcare workers included. This project will work with 18 NHS trusts across England to gather the evidence needed at a scale which will allow researchers to determine who is most at risk and recommend what support they may require.
Two further projects will concentrate on those with the most serious mental health problems, with one hoping to minimise suicide rates by assessing self-harm rates, clinical contact and risks of suicide and early death before, during and after the first Covid-19 peak, and the other exploring how people with severe mental illness experience the pandemic restrictions and their social consequences.
Professor Dame Ottoline Leyser, Chief Executive of UKRI, said: “Covid-19 has brought challenges for us all, with frontline workers facing unprecedented pressure and many others, including children and people with existing mental health issues, struggling with the anxiety and loneliness that come with social distancing measures.
“At a time when we face a long and uncertain winter ahead of us, it’s more important than ever that we continue to look out for one another. These studies will help us identify the people most at risk so that support can be targeted where it is most needed during this difficult time.”
Professor Chris Whitty, Chief Medical Officer for England and Head of the NIHR, said: "Mental health is one of the major challenges of the COVID-19 pandemic and the associated restrictions that have been needed to control it.
“This new research funded by the NIHR and UKRI will help us to unpick the mental health impacts in several vulnerable groups, so we can identify those at risk sooner and make sure they can get the help they need."
Minister for Mental Health and Suicide Prevention Nadine Dorries said: “The pandemic has been a difficult time for many of us, and it is vital we do all we can to fully investigate the impact that COVID-19 has had on our mental health.
“These projects will help us better understand how the pandemic has impacted on the mental health of people who have felt the effects of coronavirus most sharply: our healthcare workers, younger people and those with serious mental health problems.
“Taken together this research will strengthen the evidence base so that we know more about how these unprecedented circumstances affect mental health, to better target interventions and prevent serious mental health problems developing.”
This latest group of projects form part of a rolling call for research proposals on Covid-19, jointly funded by UKRI and the NIHR in response to the pandemic, and includes research on treatments, vaccines and the spread of the virus.
Enabling Child and Adolescent Mental Health Services (CAMHS) to provide efficient remote treatment for child anxiety problems in the COVID-19 context - Professor Cathy Creswell, University of Oxford - £495k
This research will evaluate an online therapy programme for children with anxiety problems, to see if it is an effective remote alternative to existing mental health treatment services and could help treat anxiety problems during the COVID-19 pandemic. NHS Child and Adolescent Mental Health Services (CAMHS) face major challenges in delivering psychological treatments remotely. Furthermore professionals will need to access increasingly efficient treatments if referrals to mental health services increase as expected now social distancing measures have been relaxed and schools reopened. This research will evaluate a therapist-supported, online cognitive behaviour therapy with more than 500 children with anxiety aged 5-12 years and their parents and carers. The study will compare the online programme with current CAMHS provision to see if it is as effective and could save money.
Details of the additional five projects
Understanding and mitigating the psychosocial impact of the COVID-19 pandemic on NHS staff in England - Professor Simon Wessely, King’s College London - £530k
This project will seek to understand and mitigate the impact of the Covid-19 pandemic on the psychological health and wellbeing of NHS staff in England. There have been several surveys reporting negative effects of the pandemic on the mental health of healthcare workers, but large-scale population-based studies are needed to confirm these effects and to what extent they persist. The researchers plan to achieve this by working with 18 NHS trusts across England to collate data on a mass scale and evaluate national and local staff support schemes. They will use a combination of online questionnaires developed alongside healthcare staff, and work with a smaller group of participants to conduct more detailed interviews. Their health and wellbeing will be assessed at regular intervals across the next 12 months. The aim of the project is to identify those most at risk and in need of tailored support. The project will rely heavily on patient and public involvement, and each trust will work with a partner with a background in equality and diversity to ensure strong representation of Black, Asian and minority ethnic healthcare workers.
Intersections of ethnicity, gender, poverty and mental health in adolescence in the context of COVID-19 - Professor Craig Morgan, King’s College London - £321k
This project will consider how ethnicity, gender and socioeconomic status influence the impact of the COVID-19 pandemic on young people’s mental health. All young people are affected to some extent by the pandemic and related social restrictions, but people in low-income households, in black and minority ethnic groups, or with pre-existing mental health problems are especially vulnerable. These researchers will work with a socially and ethnically diverse group of around 2,000 young people aged 14-17 who have been previously recruited for the Resilience, Ethnicity, and AdolesCent Mental Health (REACH) research project. The researchers aim to understand which groups of young people are most likely to experience emotional distress resulting from COVID-19 pandemic, and why. These findings will be used to identify factors that could protect at-risk young people from poor mental health and develop new approaches to prevent mental health problems in disadvantaged and vulnerable young people.
SCAMP-COVID-19: a school-based cohort study of COVID-19 secondary impacts on mental health - Professor Mireille Toledano, Imperial College London - £304k
This study will evaluate the effects of the COVID-19 pandemic and public health measures on adolescent mental health and wellbeing. School closures and social distancing during the pandemic may change the behaviour of young people, with increasing screen-time, decreased opportunities for social and physical activity, and loss of opportunities to socialise with friends. This research will work with around 5,000 London teenagers aged 15-17 years who are taking part in the Study of Cognition, Adolescents and Mobile Phones (SCAMP), which has been collecting comprehensive data on young people’s mental health, brain function, use of digital technology and behaviour since 2014. The new research will investigate risk factors for mental health problems due to COVID-19 restrictions - including whether changes in use of digital technology during the pandemic have had an impact on adolescent mental health - and explore what factors promote resilience to mental health problems.
Self-harm rates, clinical contact and risks of suicide and early death before, during and after the COVID-19 peak: cohort study of linked health data - Professor Roger Webb and Dr Sarah Steeg, University of Manchester - £159k
This project hopes to minimise the risks of suicide and early death that could have increased for some vulnerable groups during the pandemic. Previous evidence has shown a strong link between rates of self-harm and the risk of suicide. This project will assess self-harm rates, GP referrals for mental health treatment and the risks of suicide and early death before, during and after the first Covid-19 peak. The pandemic has affected people differently so the team will examine differences by age, gender, ethnicity, existing mental or physical illness and social deprivation. They will use patient data from the Clinical Practice Research Datalink (CPRD), which contains over 11 million anonymised medical records from general practitioners and is funded by the NIHR. The findings will be shared rapidly and provide essential evidence for informing suicide prevention strategies.
Optimising Wellbeing during Self-isolation (OWLS) - Dr Emily Peckham, University of York - £195k
The Optimising Wellbeing during Self-isolation (OWLS) study will explore how people with severe mental ill health (SMI) experience the social restrictions placed on them by the pandemic. People with SMI are at greater risk of being affected by limited social interactions. The team leading the project are in a unique position to assess the impact of the pandemic on this group as they have previously assembled a research-ready cohort of over 10,000 people with SMI. The participants in this group will be followed for the next 12 months to track their access to health services, their use of the internet, and their contact with friends. The results of the study will be used to make recommendations about how best to support people with severe mental illness during a pandemic.